2023-06-212022/23:SoU15 · p.3SoUHealth & social services

Medication review

Right to a medication review

What's at stake: Medication reviews are meant to catch incorrect or unsuitable medication use, which matters especially for older people and other patients on multiple medicines; the scope of the rules determines how many people gain the right to such a review.

Case texts and AI reasoning are AI-translated from the Swedish originals; the Swedish text is authoritative.

What the vote decides

The question is whether the rules on medication reviews should be expanded, by removing the age and quantity limits and introducing new requirements for regular reviews for older people in care homes, or whether the existing regulations are considered sufficient.

Yes Yes — the committee proposal

The committee points to existing regulations from the National Board of Health and Welfare already setting out the conditions under which medication reviews must be offered to patients, and maintains that the national medication list improves patient safety, concluding there is no reason for the Riksdag to take any initiative.

No No — the reservations

Reservation 6 (C, MP)

The dissenters want the government to review removing the age and quantity limits on the right to a simplified medication review, clarify doctors' responsibility to carry out a review at every prescription, and introduce a requirement for in-depth reviews when older people move into care homes and annually thereafter.

Summarised from the committee report. Party labels in the summary come from the report, not from the vote.

VSMPCLKDMSD
YesNoAbstainAbsent

What do the votes mean here?

Yes The committee proposal: rejecting the motions (keeping things as they are).

No Backing the counter-proposal: reservation 6 by C, MP.

Abstain The party marks a position of its own that is not one of the two final alternatives.

What each plan points to — and how the party voted

For each party: the vote its own election manifesto and party programme point to in this case, next to how the party actually voted. A plan can only point to Yes or No; a party can also abstain.

PlanVoteConfidenceEvidence
VNoYes 21/0/0/3departs from the planconfidence: mediumnot addressed
SNoYes 93/0/0/14departs from the planconfidence: mediumnot addressed
MPown reservationNoNo 0/15/0/3follows the planconfidence: highnot addressed
Cown reservationNoNo 0/21/0/3follows the planconfidence: lownot addressed
LNoYes 14/0/0/2departs from the planconfidence: mediumnot addressed
KDNoYes 16/0/0/3departs from the planconfidence: mediumnot addressed
MNoYes 60/0/0/8departs from the planconfidence: mediumnot addressed
SDNoYes 63/0/0/9departs from the planconfidence: mediumderived

Committee proposal

The Riksdag rejects motion 2022/23:901 by Christofer Bergenblock et al. (C) claims 8-10.

Original (Swedish)

Riksdagen avslår motion 2022/23:901 av Christofer Bergenblock m.fl. (C) yrkandena 8-10.

Riksdag decision: The Riksdag said no to approximately 50 proposals dealing with dental care and medications. The proposals came in during the general motion period 2022 and deal with, among other things, medication use, pharmacies, availability of medications and dental care. The Riksdag rejects the motions and refers, among other things, to the fact that investigative work in the area is ongoing.

Counter-proposals

Plan vs actual vote

Every party, in chamber order: what its own plan pointed to, how it voted, and the reasoning behind both. Highlighted rows are where the two differ — but a vote that follows the plan is a result too, so the reasoning is there for every party.

VVänsterpartietNoYesdeparts from the plannot addressed

The plan requires that care and support be provided according to need regardless of whether one lives in special housing or receives home care, and that care is not governed by capacity in incorrectly designed systems.

Plan documents: 2022 manifesto

Reasoning and quotes

The plan requires that care and support be provided according to need regardless of whether one lives in special housing or receives home care, and that care is not governed by capacity in incorrectly designed systems. It wants to invest more resources in healthcare and elderly care and asserts that position in society must not determine what care one receives. Removing age and number limits for medication reviews and requiring in-depth reviews for the elderly follows from this.

Original (Swedish)

Planen kräver att vård och omsorg ges efter behov oavsett om man bor på särskilt boende eller har hemtjänst, och att vården inte styrs av kapaciteten i felaktigt konstruerade system. Den vill satsa mer resurser på sjukvården och äldreomsorgen och slår fast att position i samhället inte får avgöra vilken vård man får. Att ta bort ålders- och antalsgränser för läkemedelsgenomgångar och kräva fördjupade genomgångar för äldre följer av det.

  • care according to needdecisive»Vård och omsorg måste ges efter behov oavsett om du bor på ett särskilt boende eller har insatser av hemtjänsten.« (2022 manifesto ↗)“Care and support must be provided according to need regardless of whether you live in special housing or receive home care services.”
  • needs before system boundaries»Vård måste ges efter människors behov och inte efter kapaciteten i felaktigt konstruerade system.« (2022 manifesto ↗)“Care must be provided according to people's needs and not according to capacity in incorrectly designed systems.”
  • more resources for elderly care»Därför vill Vänsterpartiet satsa mer resurser på hälso- och sjukvården och äldreomsorgen« (2022 manifesto ↗)“That is why the Left Party wants to invest more resources in healthcare and elderly care”
  • equal care»Din försäkring eller position i samhället ska inte avgöra vilken vård du får.« (2022 manifesto ↗)“Your insurance or position in society shall not determine what care you receive.”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

SSocialdemokraternaNoYesdeparts from the plannot addressed

The plan wants a new care for elderly act that ensures equally good care throughout the country and access to nurses round the clock, and that oversight of care is stepped up to guarantee quality.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan wants a new care for elderly act that ensures equally good care throughout the country and access to nurses round the clock, and that oversight of care is stepped up to guarantee quality. Extended entitlement to medication reviews and demands for thorough reviews when moving into residential care are measures of precisely that kind. The counter-proposal's demands are therefore supported in substance.

Original (Swedish)

Planen vill ha en ny äldreomsorgslag som säkerställer lika bra omsorg i hela landet och tillgång till sjuksköterskor dygnet runt, och att tillsynen av vården växlas upp för att garantera kvaliteten. Utvidgad rätt till läkemedelsgenomgångar och krav på fördjupade genomgångar vid inflyttning i vård- och omsorgsboende är åtgärder av just det slaget. Motförslagets krav stöds därför i sak.

  • statutory quality in elderly caredecisive»Vi vill ha en ny äldreomsorgslag som säkerställer att alla får en lika bra omsorg i hela landet och tillgång till sjuksköterskor dygnet runt.« (2022 manifesto ↗)“We want a new care for elderly act that ensures that everyone receives equally good care throughout the country and access to nurses round the clock.”
  • safe old age»Det ska vara tryggt att åldras i Sverige.« (2022 manifesto ↗)“It shall be safe to grow old in Sweden.”
  • quality-assured care»Tillsynen av sjukvården ska växlas upp för att garantera kvaliteten.« (2022 manifesto ↗)“Oversight of healthcare shall be stepped up to guarantee quality.”
  • care according to need»välfärdstjänsterna fördelas efter behov.« (party programme ↗)“welfare services are distributed according to need.”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

MPMiljöpartietNoNofollows the plannot addressed

The party programme confirms that the treating physician must have knowledge of the entire patient's disease picture and treatment for care to be patient-safe, and that no patient shall be harmed.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The party programme confirms that the treating physician must have knowledge of the entire patient's disease picture and treatment for care to be patient-safe, and that no patient shall be harmed. This supports the counter-proposal's requirement for medication reviews without age and number limits, clear physician responsibility and in-depth reviews upon moving into care and support housing. The plan also emphasizes that medication consumption is a patient safety problem and wishes to improve care for the elderly.

Original (Swedish)

Partiprogrammet slår fast att den behandlande läkaren måste ha kunskap om hela patientens sjukdomsbild och behandling för att vården ska vara patientsäker, och att ingen patient ska komma till skada. Det bär motförslagets krav på läkemedelsgenomgångar utan ålders- och antalsbegränsning, tydligt läkaransvar och fördjupade genomgångar vid inflyttning i vård- och omsorgsboende. Planen betonar också att läkemedelskonsumtionen är ett patientsäkerhetsproblem och vill förbättra vården för äldre.

  • complete picture for patient-safe caredecisive»Det är viktigt att behandlande läkare har kunskap« (party programme ↗)“It is important that the treating physician has knowledge of”
  • medication as patient safety risk»läkemedelskonsumtionen i dag är ett problem både« (party programme ↗)“medication consumption today is a problem both”
  • no patient shall be harmed»En av grundprinciperna i vården är att ingen« (party programme ↗)“One of the basic principles in care is that no”
  • better care for the elderly»förbättra vård och omsorg för äldre och stärka resurserna till hemsjukvården.« (2022 manifesto ↗)“improve care and support for the elderly and strengthen resources for home care.”
CCenterpartietNoNofollows the plannot addressed

The plan wants to give everyone the right to a fixed doctor contact and lift quality in healthcare and elderly care, with secure old age as a goal.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan wants to give everyone the right to a fixed doctor contact and lift quality in healthcare and elderly care, with secure old age as a goal. Comprehensive medication reviews at admission to care and elderly facilities and clearer doctor responsibility serve that commitment. At the same time, the plan wants to reduce administrative burden in healthcare, which argues against new mandatory procedures and makes support weakly grounded.

Original (Swedish)

Planen vill ge alla rätt till en fast läkarkontakt och lyfta kvaliteten i sjukvården och äldreomsorgen, med en trygg ålderdom som mål. Fördjupade läkemedelsgenomgångar vid inflyttning i vård- och omsorgsboende och ett tydligare läkaransvar tjänar det åtagandet. Samtidigt vill planen minska den administrativa bördan i vården, vilket talar mot nya obligatoriska moment och gör stödet svagt underbyggt.

  • fixed doctor contactdecisive»Vi vill ge alla rätt till en fast läkarkontakt.« (2022 manifesto ↗)“We want to give everyone the right to a fixed doctor contact.”
  • improved quality in elderly care»Kvaliteten i sjukvården och äldreomsorgen ska lyftas.« (2022 manifesto ↗)“Quality in healthcare and elderly care must be improved.”
  • secure old age»Alla ska kunna få en trygg ålderdom med hög livskvalitet och värdighet.« (party programme ↗)“Everyone must be able to have a secure old age with high quality of life and dignity.”
  • reduced administration»Den administrativa bördan inom vården måste minska, bland annat med hjälp av digitala verktyg som är användbara och efterfrågade av medarbetarna.« (2022 manifesto ↗)“The administrative burden in healthcare must decrease, partly through digital tools that are useful and demanded by staff.”
LLiberalernaNoYesdeparts from the plannot addressed

The plan gives every patient the right to a permanent doctor and wants patient responsibility to lie in primary care because it especially benefits those with multiple illnesses and the elderly, and municipalities shall be able to employ doctors in elderly care.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The plan gives every patient the right to a permanent doctor and wants patient responsibility to lie in primary care because it especially benefits those with multiple illnesses and the elderly, and municipalities shall be able to employ doctors in elderly care. Removing age and number limits for medication reviews and clarifying the doctor's responsibility follow from that patient responsibility, as does the demand for review upon admission to care and housing facilities. Medication reviews are not explicitly mentioned.

Original (Swedish)

Planen ger varje patient rätt till en fast läkare och vill att patientansvaret ligger i primärvården eftersom det särskilt gynnar multisjuka och äldre, samt att kommuner ska kunna anställa läkare i äldreomsorgen. Att ta bort ålders- och antalsgränser för läkemedelsgenomgångar och tydliggöra läkarens ansvar följer av det patientansvaret, liksom kravet på genomgång vid inflyttning till vård- och omsorgsboende. Läkemedelsgenomgångar nämns inte uttryckligen.

  • clear doctor responsibility in primary caredecisive»Ett husläkarsystem där patientansvaret ligger i« (party programme ↗)“A GP system where patient responsibility lies in”
  • permanent doctor contact»Du ska ha rätt till en fast läkare på din vårdcentral som har tid för – och som lär känna – just dig.« (2022 manifesto ↗)“You shall have the right to a permanent doctor at your health centre who has time for – and who gets to know – you personally.”
  • doctors in elderly care»vill vi ta bort förbudet för kommuner att anställa läkare i äldreomsorgen.« (2022 manifesto ↗)“we want to remove the prohibition for municipalities to employ doctors in elderly care.”
  • strengthened quality in elderly care»äldreomsorgens kvalitet behöver stärkas.« (party programme ↗)“the quality of elderly care needs to be strengthened.”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

KDKristdemokraternaNoYesdeparts from the plannot addressed

The plan establishes that medicines are an essential part of most treatment methods and that care shall be safe for patients and evidence-based, and that elderly care shall be based on a holistic view of the individual.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The plan establishes that medicines are an essential part of most treatment methods and that care shall be safe for patients and evidence-based, and that elderly care shall be based on a holistic view of the individual. The manifesto requires increased medical expertise in elderly care and fixed doctor contact. Extended and recurring medication reviews follow from these commitments.

Original (Swedish)

Planen slår fast att läkemedel är en väsentlig del av de flesta behandlingsmetoder och att vården ska vara säker för patienterna och evidensbaserad, och att äldres vård ska utgå från en helhetssyn på den enskilde. Manifestet kräver ökad medicinsk kompetens i äldreomsorgen och fast läkarkontakt. Utökade och återkommande läkemedelsgenomgångar följer av dessa åtaganden.

  • role of medicinesdecisive»Läkemedel är en väsentlig del av de flesta« (party programme ↗)“Medicines are an essential part of most”
  • patient-safe care»Den solidariskt finansierade hälso- och sjukvården ska vara ändamålsenlig och kostnadseffektiv, säker för patienterna och baserad på kunskap och beprövad erfarenhet, det vill säga evidensbaserad.« (party programme ↗)“The solidaristic-financed healthcare shall be appropriate and cost-effective, safe for patients and based on knowledge and proven experience, that is evidence-based.”
  • medical expertise in care»Ökad medicinsk kompetens inom äldreomsorgen.« (2022 manifesto ↗)“Increased medical expertise in elderly care.”
  • fixed doctor contact»Inför fast läkarkontakt med en namngiven läkare« (2022 manifesto ↗)“Introduce fixed doctor contact with a named doctor”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

MModeraternaNoYesdeparts from the plannot addressed

The plan wants the responsible physician contact to form the hub in elderly care and that medical expertise and continuity be strengthened within elderly care.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan wants the responsible physician contact to form the hub in elderly care and that medical expertise and continuity be strengthened within elderly care. The counter-proposal's requirement for clearer physician responsibility in prescribing and for in-depth medication reviews at admission to care and welfare housing and thereafter annually realizes precisely this. The plan therefore supports the requirement in substance.

Original (Swedish)

Planen vill att den patientansvariga läkarkontakten ska utgöra navet i äldres sjukvård och att den medicinska kompetensen och kontinuiteten stärks inom äldreomsorgen. Motförslagets krav på tydligare läkaransvar vid ordination och på fördjupade läkemedelsgenomgångar vid inflyttning till vård- och omsorgsboende och därefter årligen förverkligar just detta. Planen stöder därför kravet i sak.

  • the physician as hub in elderly caredecisive»Se till att den patientansvariga läkarkontakten ska utgöra navet i äldres sjukvård« (2022 manifesto ↗)“Ensure that the responsible physician contact forms the hub in elderly care”
  • medical expertise and continuity»Den medicinska kompetensen och kontinuiteten måste stärkas inom äldreomsorgen.« (2022 manifesto ↗)“Medical expertise and continuity must be strengthened within elderly care.”
  • quality requirements in elderly care»Samma krav ska naturligtvis kunna ställas på äldreomsorgen, när den behövs på ålderns höst. Det är en anständighetsfråga.« (2022 manifesto ↗)“The same requirements should of course be able to be placed on elderly care, when it is needed in old age. It is a matter of decency.”
  • safe and dignified old age»Äldre har en självklar rätt till en trygg och värdig ålderdom« (party programme ↗)“Older people have an obvious right to a safe and dignified old age”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

SDSverigedemokraternaNoYesdeparts from the planderived

The election manifesto wants to invest in primary care with a responsible physician and establishes that elderly multi-disease patients need proper care quickly instead of ending up in acute care.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The election manifesto wants to invest in primary care with a responsible physician and establishes that elderly multi-disease patients need proper care quickly instead of ending up in acute care. The party programme requires national quality standards in care and health services that must not be undercut. Removing age and number limits for medication reviews and requiring in-depth reviews when moving into care homes therefore aligns with the plan.

Original (Swedish)

Valmanifestet vill satsa på primärvården med patientansvarig läkare och slår fast att äldre multisjuka behöver rätt vård snabbt i stället för att hamna på akuten. Principprogrammet kräver nationella kvalitetskrav i vård och omsorg som inte får underskridas. Att ta bort ålders- och antalsbegränsningen för läkemedelsgenomgång och kräva fördjupade genomgångar vid inflyttning i omsorgsboende ligger därför i linje med planen.

  • care adapted for elderly multi-disease patientsdecisive»All forskning pekar på att akuten är det absolut sämsta stället för äldre multisjuka att vistas på – de behöver lugn och ro och få vård snabbt.« (2022 manifesto ↗)“All research points to acute care being the absolute worst place for elderly multi-disease patients to stay – they need peace and quiet and to get care quickly.”
  • responsible physician»Satsningar på primärvården med större patientkontakt och samordning av en patientansvarig läkare kan avlasta akut- och specialistvården genom snabbare vård.« (2022 manifesto ↗)“Investments in primary care with greater patient contact and coordination by a responsible physician can ease acute and specialist care through faster care.”
  • national quality standards»Nationella kvalitetskrav inom vård och omsorg måste finnas och får inte underskridas.« (party programme ↗)“National quality requirements for care and health services must exist and must not be undercut.”
  • integrated patient information»Införa ett nationellt patientjournalsystem« (2022 manifesto ↗)“Introduce a national patient record system”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

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Sources and documents

Documents under consideration

Source: The Swedish Parliament